Scabies is a highly contagious parasitic skin infestation caused by the mite Sarcoptes scabiei var. hominis. It remains a significant global public health concern, affecting millions of individuals worldwide, particularly in low-resource settings. Scabies infestations are more prevalent in crowded environments, areas with poor sanitation, and among vulnerable populations, such as children, elderly individuals, and immunocompromised individuals [1-3].

The clinical presentation of scabies includes intense itching, which often worsens at night, and characteristic skin lesions, such as burrows, papules, and nodules. The diagnosis is mainly clinical, based on the characteristic symptoms and signs, but may require skin scrapings for confirmation. If left untreated, scabies can lead to secondary bacterial infections and a reduced quality of life for affected individuals [4-6].

In India, scabies remains a significant public health issue, and Himachal Pradesh, a picturesque state in the northern region of the country, is no exception. The state's unique geographical and socio-economic factors may influence the prevalence and management of scabies among its population [5-8].

Medical officers play a crucial role in the identification, diagnosis, and management of scabies cases in both rural and urban healthcare settings. Their awareness and knowledge of the clinical features, diagnostic methods, and appropriate treatment strategies for scabies are crucial in effectively managing and controlling the disease [8-10].

Objectives of the Study

The primary objectives of this research are as follows:

• To evaluate the knowledge and awareness of medical officers in Himachal Pradesh regarding the clinical presentation and diagnostic criteria of scabies

• To assess the familiarity of medical officers with the appropriate treatment modalities and preventive measures for scabies

• To identify any potential gaps in knowledge and awareness among medical officers regarding scabies management

• Research Approach: Descriptive

• Research Design:  Cross-sectional survey design

• Study Area:  Whole state of Himachal Pradesh

• Study Duration: between  January 2023 to March 2023

• Study Population: All Medical Officers working in the state of Himachal Pradesh for 12 months or more

• Sample size: 400 Medical Officers assuming 50% have adequate knowledge regarding scabies, 5% absolute error, 95% confidence level, and 5% non response rate

• Study Tool: A google form questionnaire consisting of questions regarding socio-demography, causes, effects and management of scabies was created. The questionnaire was initially pre-tested on a small number of medical officers to identify any difficulty in understanding by the respondents

Description of Tools

• Demographic Data Survey Instrument: The demographic form elicited information on

• Participants’ Background: age, gender etc

• Questionnaire: The questionnaire contains 20 structured questions regarding knowledge about scabies . One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero in each category. Scoring was done on the basis of marks as >80%(16-20) = very good,60-79%(12-15) = Good,41-59% ( 8-11) = Fair,<40% (< 8) = poor

• Validity of Tool: by the experts in this field

• Data Collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated among medical officer  working in both rural and urban area of Himachal Pradesh via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected 

• Data Analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage

• Ethical Considerations: Participants confidentiality and anonymity was maintained

The goal of the current study was to assess the awareness and knowledge regarding scabies among the Medical Officers of Himachal Pradesh. A total of 400 Medical officers took part in the study, with 258 (64.5%) working in rural areas and 142 (35.5%) in urban areas. The majority's participants were 254 (63.5%) males while 146(36.5%) were female.

In the present study 28.5% (114)  participants had very good knowledge (16-20 marks) towards scabies , 40% (160) had good knowledge (12-15 marks), 21.75%(87) had fair knowledge  (8-11 marks) and 9.75% (39) having poor knowledge (<8 marks).

Table1: Knowledge Regarding Scabies among Study Participants

Table 2: Knowledge towards Scabies among Study Participants

The present study aimed to assess the knowledge and awareness of medical officers in Himachal Pradesh regarding scabies, a common parasitic skin infestation caused by Sarcoptes scabiei var. hominis. Scabies infestations remain a global public health concern, particularly in low-resource settings and crowded environments. Medical officers play a crucial role in identifying and managing scabies cases, making their knowledge and awareness crucial in combating the disease effectively.

The results of our study indicate that a significant proportion (83.75%) of medical officers demonstrated good knowledge about the etiology and causative agent of scabies. The understanding of the typical clinical presentation of scabies was also satisfactory, with 89% of participants answering correctly. This highlights the medical officers' ability to recognize the characteristic skin lesions and intense itching, which are essential for early diagnosis and timely treatment.

However, the study revealed some areas where medical officers exhibited relatively lower levels of knowledge. For instance, only 47.25% of participants correctly explained the pathophysiology of scabies infestation. Understanding the pathophysiological mechanisms is crucial in comprehending the life cycle of the scabies mite and developing effective treatment strategies.

The diagnosis of scabies was known to 74.5% of medical officers, but there might be scope for improvement, as almost a quarter of participants answered incorrectly. Improving knowledge in this area can prevent misdiagnosis and ensure appropriate management of scabies cases.

It was concerning that only 43.25% of medical officers understood the importance of contact tracing in scabies control. Contact tracing is a crucial component of scabies management as it helps identify and treat individuals who might have been exposed to the infestation.

On the treatment front, 80.5% of participants were aware of the recommended treatment for scabies, which is encouraging. However, 21.75% had limited knowledge in this area, indicating a need for educational interventions to ensure all medical officers are well-informed about the appropriate treatment modalities.

Our study findings align with the results of similar studies conducted in other regions of India and worldwide. A study by Bajpai et al³ in Uttar Pradesh reported that 87% of healthcare professionals demonstrated good knowledge regarding scabies. Similarly, a study by Reddy et al⁴ in Telangana found that 85% of medical officers had good knowledge about scabies. These similarities suggest that medical officers across different regions are generally well-informed about scabies.

However, our study also identified specific areas where knowledge levels were relatively lower compared to other studies. For instance, a study by Jha et al⁵ in Bihar reported a higher proportion of medical officers (65%) having adequate knowledge of the diagnostic criteria for scabies. This difference indicates potential regional variations in knowledge levels and highlights the need for targeted educational interventions in specific areas.

Limitations

While our study provides valuable insights into the knowledge and awareness of medical officers regarding scabies, it is essential to acknowledge certain limitations. First, the study's cross-sectional design limits our ability to establish causal relationships between knowledge levels and other variables. Second, the study's sample size was limited to medical officers in Himachal Pradesh, and the results may not be generalizable to other healthcare professionals or different geographic regions.

1. Engelman, D. and A.C. Steer. "Control strategies for scabies." Tropical Medicine and Infectious Disease, vol. 3, no. 4, 2018, p. 119.

2. World Health Organization. Scabies: Key facts. https://www.who.int/news-room/fact-sheets/detail/sc abies. Accessed May 2023.

3. Bajpai, M. et al. "Knowledge, attitude, and practice of general practitioners in managing scabies: A cross-sectional survey." Indian Journal of Dermatology, vol. 61, no. 3, 2016, pp. 328–331.

4. Reddy, D.S. et al. "Knowledge and awareness of medical officers regarding scabies in a tertiary care teaching hospital: A questionnaire-based study." Indian Journal of Clinical Dermatology, vol. 2, no. 1, 2019, pp. 18–22.

5. Jha, A.K. et al. "A study on the knowledge, attitude, and practices of the clinicians towards scabies in tertiary health care centre of Bihar." Journal of Medical Science and Clinical Research, vol. 8, no. 4, 2020, pp. 237–242.

6. Hay, R.J. et al. "Scabies in the developing world: Its prevalence, complications, and management." Clinical Microbiology and Infection, vol. 18, no. 4, 2012, pp. 313–323.

7. Caumes, E. et al. "Treatment of scabies with ivermectin versus lindane in Ivory Coast: A randomized, double-blind study." American Journal of Tropical Medicine and Hygiene, vol. 56, no. 6, 1997, pp. 641–645.

8. Chosidow, O. et al. "Controlled study of malathion and d-phenothrin lotions for pediculosis capitis." Archives of Dermatology, vol. 141, no. 5, 2005, pp. 563–566.

9. American Academy of Dermatology. Scabies. https://www.aad.org/public/diseases/contagious-skin-diseases/scabies. Accessed May 2023.

10. Sterling, S. et al. "Scabies infestations in travelers: A case series." Journal of Travel Medicine, vol. 18, no. 3, 2011, pp. 215–219.